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Key insights from the New Zealand Joint Replacement Registry Report 2025

The NZJR’s latest Annual Report portrays several important trends and outcomes in hip arthroplasty in New Zealand over 26 years (1999-2024).

Here are the takeaways to know.

Table showing revision data by bearing type in New Zealand, evaluated by CeramTec based on the 2025 New Zealand Joint Registry report (Page 28, Table 1.30), related to hip arthroplasty implant performance.
Table displaying revision data stratified by femoral head size in New Zealand, evaluated by CeramTec using the 2025 New Zealand Annual Report (Page 28, Table 1.31), relating to performance outcomes in total hip arthroplasty.

Primary hip replacement: 

Since its inception, 202,460 primary hip arthroplasties have been registered in the NZJR. From 2023 to 2024, total hip arthroplasties (THA) rose by 5%.

Fixation trends: 

Uncemented fixation led the way in 2024 (now accounting for 51.7% of procedures, with 5,728 uses out of 11,078 total procedures), followed by hybrid (44.8%, with 4,965 uses) and cemented (<5%, with 332 uses).

Bearing surfaces: 

Ceramic-on-polyethylene (CoP) is now the predominant bearing surface (>60%), while metal-on-polyethylene (MoP) is ~20%. Ceramic-on-ceramic (CoC) is under 5%, showing the lowest revision rates in the registry data.

Head size preferences: 

36mm heads are used in about half of cases, accounting for 90% of all procedures together with 32mm heads. ≤28mm and >36mm head sizes remain rare.

Revision: 

In 2024, the top reasons for revision THA were deep infection (22.8%), dislocation (19.4%), femoral fracture (18.2%), femoral loosening (14.7%), acetabular loosening (12.5%), and unexplained pain (2.9%).

  • Notably, revisions for deep infection have increased since 2012, while those for unexplained pain have dropped significantly.
  • Between 1999 and 2024, 32,275 hip revision procedures were registered in the NZJR. 1,484 new hip revisions were recorded in 2024.
  • CoC bearings show the lowest revision rates (0.46/100 component years), followed by CoP (0.55) and MoP (0.63). 32mm head sizes show the lowest revision rates among groups.

Patient-reported outcomes (PROMs): 

The Oxford-12 questionnaire shows that at 6 months, 84% of patients report excellent or good function (mean score 40.3). High satisfaction levels are maintained at five-year intervals up to 20 years post-op.

 

For more details, refer to the full NZJR Annual Report 2025:https://www.nzoa.org.nz/sites/default/files/documents/DH9492_NZOA_AnnualReport2025_FINAL.pdf

 

Note: The NZJR Annual Report is an independent registry publication and reports aggregated outcomes across multiple implant manufacturers and bearing designs. The bearing-surface categories cited (e.g., CoC, CoP, MoP) are not limited to BIOLOX® components, and this post does not report outcomes for any specific brand or product.

 

Please check for regulatory approval in your country.

 

This text was created with the support of AI.

 

📖 Reference:

New Zealand Orthopaedic Association. Twenty-six-year report January 1999 to December 2024. The New Zealand Joint Registry. Accessed December 15, 2025.

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